EVALUATION OF GENERAL ANESTHETICS IN RELATION TO TRIGEMINO-AUTONOMIC REFLEX

全身麻醉药与三叉自主反射相关的评估

• 批准号: 09672031
• 负责人: KAMEKURA Nobuhito
• 金额: $ 2.05万
• 依托单位: HOKKAIDO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09672031/
• 关键词: TRIGEMINAL NERVE; AUTONOMIC NERVE; GENERAL ANESTHETICS; ISOFLURANE; SOVOFLURANE; PROPOFOL; TRIGEMINAL DEPRESSOR RESPONSE

We investigated effects of general anesthetics on trigeminal depressor responses ( TDR), which were evoked with electrical stimulation to trigeminal nerve.These studies were performed on adult Japanese White rabbits, anesthetized with urethane and alfa-chioralose. The trachea was cannulated and a catheter placed in femoral artery. Arterial pressure and heart rate were calculated from pressure wave of femoral artery. Mental nerve was stimulated with 10S train of squarewave pulses (0.5mS duration). Records of nerve activities were obtained from cervical sympathetic nerve and vagal nerve.In preliminary study, we determined that the optimal frequency and intensity range which evoked trigeminal depressor response was 5Hz and 5-20mA.In this study, mental nerve was stimulated in these manners.We examined two volatile anesthetics (isoflurane and sevoflurane ) and one intravenous anesthetic (propofol).In isoflurane and sevoflurane, degree of fall in blood pressure became smaller as inspired concentration of anesthetics became higher. TDR disappeared in almost 0.75-1.0 MAC ( tail clamp method). 1.0 MAC of tail calmp method is said to be equivalent to plane 3 or 4 of third stage in Guedel's clinical signs. It is suggested that concentration necessary to suppress TDR is rather high in isoflurane and sevoflurane.On the other hand, effects of propofol on TDR were minimum. In administration rate of 125 mg/kg/hr, which was extremely high dosage, about 8% of fall in blood pressure evoked with mental nerve stimulation was observed. So we concluded that propofol could not disappear TDR completely. It is suggested that proper blocked of noxious stimulation is necessary when general anesthesia is performed with propofol for oral surgery.

本研究在乌拉坦和α-氯醛糖麻醉的成年日本白色家兔上观察了全身麻醉药对电刺激三叉神经诱发的三叉神经降压反应（TDR）的影响。气管插管并将导管置于股动脉中。根据股动脉压力波计算动脉压和心率。用10 S的方波脉冲串（持续时间为0.5mS）刺激颏神经。本实验用颈交感神经和迷走神经记录神经活动，初步确定诱发三叉神经降压反应的最佳频率和强度范围为5 Hz和5- 20 mA。本实验用这两种方式刺激颏神经，并对两种挥发性麻醉药进行了比较在异氟烷和七氟烷中，随着麻醉剂吸入浓度的增加，血压下降的程度变小。TDR在0.75- 1.0MAC（夹尾法）时消失。1.0尾部平静法的MAC相当于Guedel第三阶段临床体征的平面3或平面4。提示异氟醚和七氟醚抑制TDR所需的浓度较高，而异丙酚对TDR的影响较小。在极高剂量125 mg/kg/hr的给药速率下，观察到由精神神经刺激诱发的血压下降约8%。因此，我们认为异丙酚不能完全消除TDR。提示在口腔手术中应用异丙酚全麻时，应适当阻断伤害性刺激。

项目成果

亀倉 更人: "家兎オトガイ神経電気刺激による循環反射の検討-第2報 血流量による検討-" 日本歯科麻酔学会雑誌. 25・4. 607 (1997)

Sarato Kamekura：“通过电刺激家兔精神神经进行循环反射检查 - 基于血流量的检查”第 2 期报告《日本牙科麻醉学会杂志》25・4（1997 年）。